I've written about health care for more than two decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary Clinton through the Hawkeye state talking health reform and the economy. I have covered the rise, fall and rise again of health reform, chronicling national trends as well as the influence of Barack and Michelle Obama from Chicago's South Side on changes to the U.S. health system from my base in Chicago. I am the author of the new Forbes signature series book, "Inside Obamacare: The Fix For America's Ailing Health Care System." I was health care business reporter at the Chicago Tribune (1998-2011) and previously wrote for Modern Healthcare magazine when first arriving in Chicago in 1993. Prior to that, I wrote for several Iowa newspapers including the Des Moines Register. These days, I contribute stories to the New York Times, Chicago Medicine magazine and teach in the University of Iowa School of Journalism MA in Strategic Communication program. You can see me nationally on Fox News Channel's "Forbes on Fox" show. In Chicago, you can hear my health segments and business analysis on WBBM newsradio 780 and 105.9 FM. I am passionate about health literacy when it comes to explaining the complexities of health care. A better understood health system may save someone some money or their life.

A report by consulting firm Accenture says one in four consumers who obtain benefits through their employers will do so via private exchanges, a concept growing as rapidly as the public exchanges under the Affordable Care Act. (Photo credit: Wikipedia)

As the uninsured prepare to sign up to public online marketplaces known as exchanges under the Affordable Care Act, a flood of employers are taking to a similar private sector approach, led by last week’s move by WalgreenWalgreen Co. (WAG), according to employer surveys and benefit consultancies.

A report last week by consulting giant AccentureAccenture said more than one in four, or 27 percent of consumers who obtain benefits through their employers will by 2018 receive their benefits through a private exchange, a new concept whereby employers are giving their workers money to buy health benefits via private online marketplaces known as exchanges. Walgreens will be the largest employer thus far to join its AonAon Hewitt Corporate Health Exchange, bringing more than 160,000 eligible employees to such coverage in 2014.

Aon Hewitt (AON), a large employee benefits consultancy, said last week that 17 employers will join Walgreens in 2014 turning to a new concept whereby employers are giving their workers money to buy health benefits via private online marketplaces known as exchanges.

Though the concept used by Walgreen and a growing number of employers is in the private sector, the exchange is akin to the state and federally-regulated marketplaces that in less than two weeks will offer uninsured individuals subsidized benefits under the Affordable Care Act.

“These public exchanges will expand and standardize coverage for an estimated 30 million individuals by 2017,” the consulting giant Accenture said in its report. “However, this transformation is also paving the way for the rapid growth of another quietly emerging channel. Private health insurance exchanges have been incubating for several years, but the accelerated development of exchange products and technologies has employers increasingly re-evaluating traditional employee benefits.”

This doesn’t mean these private employers like Walgreen are throwing their employees out of employer-based coverage, nor are they ending financial support of worker benefits. Rather, it allows more worker choice through an online selection process but could also allow employers to better control or even reduce the credit or subsidy they provide workers to buy via the exchanges.

Accenture’s report said 50 percent of consumers are “intrigued by the choice and flexibility the new platforms would offer.” Accenture is projecting private exchange enrollment will eventually surpass the government-run exchanges by 2018.

The private exchanges work like those that are expected to be operational by states or the federal government next month under the Affordable Care Act next year in that they offer consumers more choices plus people who buy coverage are empowered to make choices for their individual needs, benefits consultants say. Open enrollment for uninsured individuals under the health law begins Oct. 1 and runs through next March.

Under the health law signed into law by President Obama, millions of Americans in January of next year who have no coverage will receive federal subsidies of about $5,000 to help them buy coverage from health insurance companies that sell individual and small group policies. That subsidized coverage will be offered on exchanges as well but those marketplaces will be operated by each state or the federal government or a partnership between state insurance administrations and the U.S. Department of Health and Human Services depending on the state.

Thus, Walgreen and other employees are not headed to an open market like the uninsured under the health law who will sign up for coverage on government-run exchanges.

Aon Hewitt’s exchange works with each employer in the exchange deciding on the subsidy or “credit” that each worker will get to purchase coverage offered by the employer. Then, the employees take to the AON Hewitt exchange to select their coverage. The subsidy will vary from employer to employer.

“A private (health insurance) exchange is an online benefits marketplace that lets individuals shop for insurance products including health, dental, vision, life, auto and home,” Accenture said in its report. “Typically an employer will provide a “defined contribution” (e.g., $5,000 that works like a gift card) that can be used to purchase products that best meet individuals’ needs, offering greater choice and flexibility than traditionally available.”

Other consulting firms, too, are working with employers on private exchanges. Earlier this year, Mercer said that 10 insurance carriers, including AetnaAetna (AET), Cigna (CI), Humana (HUM), UnitedHealth Group (UNH) and a host of Blue Cross and Blue Shield plans signed on to the firm’s private exchange for 2014 enrollment.

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…a good place for freelancers and regular folks in searching for extra bucks… I already got my first check of $900 this week, and I worked about 2 hours in the day and 2 in the evening… It’s www.jobs95.ℭom

just like everything else the government “explores” the private sector will figure out a way to put it to use - dam near everything new was pioneered by govt contracts or subsidies for”exploration or R&D - just open your eyes and see that this is a way to break with the past insurance standards that were out of control cost wise – without any changes most citizens will not be able to afford coverage forever – and bankruptcy is what is in store for those that cant afford to pay their medical bills - stop crying about socialism – we are already a socialist based society - everything we do is spread out over a group – corporations/stocks – unions – fireman/police/military/libraries/schools – even religion has it’s base in shared socialistic support - stop being a dinosaur -

This means these employers will need to compete for employees with higher salaries. This is good for the american worker. Now you will be able to take a higher paying job somewhere else without the worry of a lapse in medical insurance. My employer see’s this threat and actually started paying all of our medical premiums and half of our vision and dental as of last month.

Big, you have 3 things in your comment bundled together. First, you say employers will need to compete for employees with higher salaries. Why? Because health insurance exchanges ? Why is that?I think there are a lot of employed and under-emloyed people who would like to get a job.So far they compete, not employers. Partially agree with number two, however if economy doing fine and I am needed both” my old and new employers usually offered me heath insurance or I will simply not apply for a work there. And finally, congrats on better insurance now from your current employer!

Because potential lapses in coverage locked certain employees in to their employer. The equivalent to the Company Store, of not so long ago. With that issue gone, the can compete on salary alone. The perfect Capitalist solution, don’t you agree?

More and more women are surviving this disease—that’s the good news. But at the same time, the number of oncology specialists is shrinking and this shortage isn’t likely to change. Why is this? A simple lack of reimbursement is driving some oncologists away from private practices and is directly contributing to new doctors no longer choosing oncology as their specialty of choice.

And what does all this mean? That by 2020, the number of oncology specialists in the United States will have shrunk to 48 percent. And ladies, no one can put 10 pounds of salt into a 5-pound bag. THANK NOBAMA AND HIS FREELOADERS FOR THIS ONE, AND IT IS NOT JUST ONCOLOGY…ALL DOCS THAT CAN RETIRE “ARE” RETIRING..

Ok so this is great….My employer gives me money to hit the Exchange with…Um well in the pocket it goes..Next step…Don’t go to the exchange..At some point quit the job and hit the emergency room…Yeah that will work

Also virtually every insurance broker that works in the mid and large market is going to have their own exchange for their clients powered by private platforms like industry leader BSwift, and others like Liazon, BenefitFocus, SmartBen and numerous others.

More options for employees, simplified online tools and an ability to fix benefits costs at a “defined contribution” level is what is driving this. Think 401K vs a traditional pension plan but for all a companies benefits from health, dental, vision, life, disability et al.

So the benefit from the federal government is 5000 dollars. The Kaiser Permante health plan charges the state of California 1856 dollars a month if one member is on medicare with 2 plus on basic covereage for out of state coverage, 1354 for in state area coveage. Pay roughly 22,000 a year and get back 5000 in tax credits when you owe zero federal taxes in the first place. With a deal like that I can get you a first class bridge in Brooklyn, make money selling tolls.

He is what is really Obama care-They did not tell you about these which will ALL be in effect by 2016..

Pg 22 – Mandates the govt will audit books of all employers who self insure. Pg 29, Lines 4-16 – Healthcare rationing. You can only receive so much care per year. $5,000 per single, 10,000 per family for preexisting conditions. Yes it does cover preexisting conditions but only for this much. Pg 107 – Dhimmitude this is the descriptive name for Muslims (look it up), Amish are exempt and do not have to pay penalties { Its is against their religions so they are exempt} They use the word Dhimmitude to slipt it through and by people. Pg 50, Section 152 – Healthcare will be provided to all non-U.S. citizens, illegal or otherwise Pg 170, line 1-3 – Any nonresident alien is exempt from individual taxes (you and I will pay for them) Pg 91, Line 4-7 – Govt mandates linquistic appropriate services, or translation for illegal aliens [ If you are not going to sign them up then why have translators?} Pg 65, Section 164 – subsidized plan for retirees and their families in unions and community organizations . Pg 58 – Govt will have real time access to individuals finances and a national ID Health card will be issued. Pg 59, line 21-24 – Govt will have direct access to your bank accounts for elective funds transfer (They will take what they think you owe them at any time) Pg 84, Section 203 – govt mandates all benefit packages for private healthcare plans in the exchange Pg 124, line 24-25 – No company can sue the govt on “price fixing” & no “judicial review” against govt monopoly Pg 195 – Officers and employees of healthcare admin (Government) will have access to all Americans financial and personal records Pg 203, line 14-15 – “The tax imposed under this section shall not be treated as a tax” Pg 239, line 14-24 – Govt will reduce physician services for medicade. Seniors, poor and low income will be affected Pg 354, Section 1177 – Govt will restrict enrollment of special needs individuals. Pg 280, Section 1151 – Govt will penalize hospitals for what the govt dems ‘preventable re-admission’. If you have to go back in for the same condition they will decide not you and your doctor. Pg 425, Line 4-12 – Govt mandates “Advanced care planning consultation”. Seniors will be interviewed every year for health issues and decisions made as to what care they can and cannot receive. Pg 469 – There will be Community based Home Medical services, such as ACORN Pg 472, Line 14-17 – Payment to community based organization. One monthly payment to a community based organization (ACORN) They will report back to the government on your compliance like Communism. Pg 425, Line 17-19 – Govt will instruct and consult regarding living will and durable powers of attorney. MANDATORY- {The government and not your family will determine your right to live} Pg 425, Line 22-25 & Page 426, Line 1-3 – Govt provides approved list of end of life resources – guiding you in death Pg 317-318, Line 21-25, 1-3 – Prohibition on Expansion: The govt mandates if hospitals can or cannot expand Pg 321, Line 2-13 – Hospitals have the opportunity to apply for exception but community input is required. ( groups like ACORN) Pg 30, Section 123 – There will be a govt committee that decides what treatments and benefits you receive.

Reading the comments is is obvious you folks think the plans under Obamacare actually cover you. They don’t. If you buy the bronze plan the lowest cost, highest deductible plan you will be bankrupt in short order should you get a high cost illness, they just can’t fire you from the plan but they can bleed your life savings dry in a heartbeat. If you buy the higher cost, less deductible plans they still bleed you to death but a a slightly lower rate as the insurance companies get to keep the 15 percent profit they are guaranteed by law. Don’t pay and off to jail you go for income tax evasion, something that will start happening about 5 years down the road as soon as the Dems can blame the Reps. Remember the Supremos said this was a tax, read up on tax exasion law.

The government is acting like a sixteen year old kid that thinks it knows everything.”If there isn’t justice for the people let there be no peace for the government.” Doing the same thing over and over is insane. Fix America First. Prioritize. Recycle America ,turn things around. The Government should fear the people, opposite of how it is now. the government should protect people and regulate corporations not protect corporations and regulate people. We need to Build a good foundation then rebuild. Reinstate common sense. Create Accountability and most of all treat our cancers greed , ignorance and self-entitlement. Our society runs the way it does because it is designed that way for the rich by the rich. There are many common sense simple ways to change things to make a better world to live in. Until we can prioritize correctly , have accountability , and worry about the American instead of the American dollar things will remain perverted. Anyone can find fault — it’s not a sign of anything other than moderate brain activity. It’s much harder to offer creative criticism that actually improves the situation for everyone involved, UNITED we stand divided we fall…there is only one race the HUMAN RACE all the divisions of political parties and skin color have demoralized this country into a sewage plant of lying stealing ignorant greedy self-entitled hypocritical idiots the government has had too much money power and time with too little results actions speak louder than words.

Well…..My husbands company took this opportunity to use, ‘and I quote’ “due to the recent changes in Health Care Reform” ROTFLMBO!!…..Our insurance provided by the company until this was around $100.00 a month. Now for the same policy with an actual deductible you could pay, 250.00/500.00 is offered for $133.00 a WEEK !! The alternative is a policy with deductibles of 2,500.00/8,500.00 is $70.00 a WEEK!! This after a pay cut of $200.00 a week or more!! Blaming Obama all the way….rotfl. My husband has worked for these billionaires for over 25yrs. waited almost 10yrs. for a raise, which brought us into the right century, now we are ruined. I am disabled, (and NO, that doesn’t mean everything is payed for you, just the opposite) my meager check of $828.00 has right at $98.00 cut out for medicare part B, that’s the one that is supposed to help with doctor visits. Good luck with finding a Doctor that takes it!! So that puts me at $728.00 per mo. Of which I pay taxes on….yes, we do have to pay taxes on it, even though my medications and Dr. visits cost way more than that!! So basically, without my husbands insurance we would starve to death. So I guess we’re gonna go hungry from here on in. They ‘dam’ sure aren’t going to give us money to buy insurance!! GREED…pure greed. We drive by their mansions and honest to God wonder how on earth they sleep at night!! I and at least one other, have had to cancel surgeries we desperately need !! When my husband was a sales rep. for these people, he made them millions of dollars, profit….but no commission. Went out constantly every day off, every day after work. Yet still made no money. I likened him to what a brain surgeon’s life must be like, except he never got ‘on call’ pay. Nothing…..ever. He was just that dedicated, (yes girls, he really was working..lol) and this is how they show their appreciation. We, of course had to take the $70.00 a week policy, and that is killing us. My husband’s eyes are wide open now, and yes he is job hunting. At the rate he’s going there, before long he’ll be able to work at Walmart and make more money. I believe if I had a guy that not only worked that hard, but was that dedicated, I’d do anything to keep him. He is now doing three people’s job, inside the office all day. When he leaves, it will cost them way more to try and replace him than it would to pay him to stay. But some people have to learn the hard way !!

Be very careful when looking for an insurance. I got scammed by a company that canceled the policy the day my wife went into the hospital. They told the hospital that I canceled it. Watch out for “USA SELECT CHOICE”. I paid them by auto pay from my account every month and they did not take out on August 1st. they took over $3000 in payments and paid out less than 20% to the doctors. Don’t get scammed like I did.

Google “Obamacare Flowchart” at Intellectual Takeout to see a visual representation of the convoluted, corrupt mess this really is

Congress,Muslims, Amish, Native Americans are exempt from mandate and penalties under Obamacare that the rest of us have to pay.

1. Millions are losing the insurance Obama promised they could keep. Because ObamaCare forces employers to offer expensive Cadillac plans but also offers the option of paying a fine for not providing health insurance that can be cheaper than providing it, between seven and twenty million Americans are likely to lose their health insurance coverage according to the Congressional Budget Office. The original estimate was closer to four million.

2. The cost of healthcare premiums is about to further skyrocket. Premium costs have already exploded, but that is a slow-motion explosion. In the near future, we could see costs double or worse. Naturally, these costs will hit an already burdened middle class hardest.

3. Lost jobs. Lost jobs.

The Federal Reserve’s March beige book on economic activity noted that businesses “cited the unknown effects of the Affordable Care Act as reasons for planned layoffs and reluctance to hire more staff.” Consulting firm Adecco found that half of the small businesses it surveyed in January either plan to cut their workforce, not hire new workers, or shift to part-time or temporary help because of ObamaCare.

4. Doctor shortages that will mean rationing: The healthcare industry is already a bureaucratic quagmire. ObamaCare is about to add steroids. As the profession becomes tyrannized by government, the talented people currently practicing medicine plan to get out sooner than expected. Who knows how many will choose not to get in. Doctor shortages are what lead to the nightmare known as rationed care.

5. Somewhere around $800 billion in tax increases will hit America’s middle class. This added burden will not only further oppress a middle class already reeling from a drop in wages over the last few years, but could damage the overall economy.

6. Inflation, the cruelest tax on the poor. When businesses get socked with added costs brought about by higher taxes and burdensome government mandates, they pass those cost along to the consumer in the form of higher prices.

7. Added bureaucracy. Even those Obama lapdogs over at the Washington Post’s Wonk Blog are admitting that applying for health care is about to get more burdensome than the byzantine paperwork involved in buying a home.

8. To cut costs or to avoid having to provide insurance, workers on the economic margins are already losing hours, which means a lower paycheck. There are a million sad stories in ObamaVille; here are just a few of them.

9. ObamaCare is projected to add $6.2 TRILLION to a deficit the GAO has already declared “unsustainable.” That’s “trillion” with a “t”.

10. More taxes than currently estimated are likely to hit because of situations like this one.

Three years ago, Obama, Democrats, and his media lied to us about cutting the cost of health care, being able to keep our insurance, and not taxing the middle class. Today, those lies and what ObamaCare is and will do to the working and middle class are the biggest untold story in America.

The govt becoming more involved in health care is the reason the costs have increased. So Govt creates a crisis, then provides a solution that comes at the expense of liberty and freedom, costs trillions, and by most accounts won’t solve the problem but in fact make it far worse.Corruption, incompetence, disregard of the Constitution, and lying are integral to the way that this country is being run.

REFUSE and Repeal Obamacare…If only a mere 20% of the over 300 million population of the USA boycott Obamacare the government would be overwhelmed to even think they could penalize or mandate every citizen that refused to participate in the most corrupt and unlawful ways which it was passed that circumvented the constitution of the United States

i thought that Obamacare was going to give to WE THE PEOPLE the same benefits that members of Congress, and the high elite of the Government enjoy paid by WE THE STUPIDS, and also it was going to create the same benefits that they enjoy….like vacations during Easter, the month of August, xmas holidays, etc., and ask the employers of USA to pay their employees also the same SALARY these people get…OH! I FORGOT, THEY ARE SERVING…LOL…THEY ARE NOT GAINFULLY EMPLOYED. And y the miracle of Saint Gov they start poor, and walk out millionaires!!! What a shame!!!

This is exactly what unions have realized and have recently rallied against….the loss of employer provided health care coverage. Companies realize that it will, in fact, be cheaper for them to have their employees purchase their own coverage on a national exchange. So the “carrot” they are offering their employees under the guise of “choice” is actually to their benefit. In some cases, it will be a “win-win.” In others, the employee may find they have purchased a far inferior product to that previously offered by the company.